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Am J Clin Nutr. 2010 Apr;91(4):860-74. doi: 10.3945/ajcn.2009.28034. Epub 2010 Feb 17.

Low-fat dietary pattern and lipoprotein risk factors: the Women's Health Initiative Dietary Modification Trial.

Author information

  • 1MedStar Research Institute, Hyattsville, MD 20782, USA. barbara.v.howard@medstar.net

Abstract

BACKGROUND:

The Women's Health Initiative Dietary Modification Trial tested the effects on chronic disease of a dietary pattern lower in fat and higher in vegetables, fruit, and grains.

OBJECTIVE:

The objective was to evaluate the effects of dietary carbohydrate changes on lipids and lipoprotein composition.

DESIGN:

Postmenopausal women were randomly assigned to an intervention or a comparison group for a mean of 8.1 y. Lipoprotein analyses and subclasses were based on subsamples of 2730 and 209 participants, respectively.

RESULTS:

At year 6, the total reported fat intake was 7.8% lower and carbohydrate intake was 7.6% higher in the intervention group than in the comparison group. Triglyceride change between groups differed by 2.3, 3.8, and -0.8 mg/dL at 1, 3, and 6 y, respectively, and HDL-cholesterol change differed by -1.6, -0.7, and -1.0 mg/dL at 1, 3, and 6 y, respectively. Changes did not differ by age, ethnicity, or obesity. In diabetic intervention women who were white, the triglyceride difference between the intervention and comparison groups was 33.8 mg/dL, whereas in black women with diabetes (n = 50 in the intervention group; n = 83 in the comparison group), the triglyceride difference was 6.4 mg/dL (P for 3-factor interaction = 0.049). No significant changes were observed in apolipoprotein or lipoprotein particles. Reductions in LDL cholesterol varied by quartile of reported lowering of saturated or trans fat.

CONCLUSIONS:

The replacement of 7-8% of fat intake with complex carbohydrates over 6 y was not associated with clinically adverse effects on triglycerides, HDL cholesterol, or lipoprotein subclasses. Diabetic white women with higher triglyceride concentrations may have greater increases in triglycerides.

Comment in

PMID:
20164311
[PubMed - indexed for MEDLINE]
PMCID:
PMC2844674
Free PMC Article

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